Organizational skills training, neurofeedback, and/or pharmacotherapy in the treatment of school-aged children with attention-deficit hyperactivity disorder

Abstract

<br><b>Background</b> Attention deficit hyperactivity disorder (ADHD) is the most common developmental and neurobehavioral disorder in childhood. It is characterized by hyperactivity, impulsivity, and/or inattention.<br><b>Objective</b> To study the efficacy of implementation of different interventional modalities including medication (MED; atomoxetine) either alone or in combination with behavioral therapy (organization skills training; OST) or cognitive training (neurofeedback training; NFT) in alleviation of the core symptoms of ADHD and its comorbid conduct problem among school-aged children with ADHD.<br><b>Participants and methods</b> This was a multigroup design study with preassessment and postassessment with the Arabic form of Conners’ Parent Rating Scale short form (CPRS-48). Participants were 45 school-aged children (age range from 6 to 10 years) with a diagnosis of ADHD according to the <i>Diagnostic and Statistical Manual of Mental Disorders</i>-5 diagnostic criteria. Children were recruited from the Pediatric Behavioral Outpatient Clinic of Alexandria University Children Hospital, Alexandria, Egypt, and they were allocated into the groups: group OST and MED (<i>n</i>=15); group NFT and MED (<i>n</i>=15); and group MED (<i>n</i>=15).<br><b>Results</b> Combined OST and MED showed a significant decrease in hyperactivity/impulsivity (<i>P</i>=0.011) and comorbid conduct problem scores (<i>P</i>=0.030) on postinterventional assessment with CPRS-48. However, no statistically significant difference was found among the other studied groups, groups NFT and MED or group MED, either on ADHD core symptoms or its comorbid conduct problem.<br><b>Conclusion</b> Combined OST and MED showed significant efficacy in the alleviation of ADHD core symptoms and comorbid conduct problem.<br>